THE 4 STAGES OF DEPRESSION AND THEIR CHARACTERISTICS - ARTE - 2024

The stages of depression can be divided into origin, onset, behavioral inhibition of pleasant activities, and behavioral inhibition of compulsory activities.

When we talk about depression, we are referring to a psychological disorder that can be very serious and seriously interferes with the person's life. It is characterized by a negative vision of the present and the future, with little hope, little desire to do things, sleeping a lot or little, among other symptoms.

Depression can affect the entire psychosocial functioning of the person and not only those who suffer from it, but also their environment and the entire society, given the economic impact that depression has on health services.

What are the stages of depression?

First stage: the origin of depression

Some years ago, some theories supported that depression was the result of a series of biochemical changes that happened in our body. Subsequent studies propose that in order for a person to become depressed, a situation must arise in their environment that the person interprets as unpleasant.

This change in the environment that is perceived is called loss of reinforcers. The loss of reinforcers would be the origin of the depression.

The origin of the disorder can be caused by a series of life changes such as illness, divorce, loss of a loved one, dismissal, family problems and other psychological disorders.

As we can see, there is no standard key moment for all people but rather it is any experience that the person interprets as a loss or an unpleasant change that they cannot adapt to or cannot cope with.

Not all unpleasant events that make us feel unwell or sad trigger depression. Sadness is a basic emotion that has a specific biological function.

The function of sadness is to decrease energy to plan how we can cope with this loss. Sometimes this period of sadness lasts longer because the person feels unable to cope with this new situation.

When this sadness is prolonged, the person begins to become depressed and a series of emotional changes, changes of thought and changes in behavior occur.

This succession of changes produces modifications in the biochemical functioning of the central nervous system. The brain secretes fewer neurotransmitters and makes it easier for depression to set in.

We can classify the loss of reinforcers as follows:

a) Great stressor or loss of positive reinforcers

Sometimes people experience the loss of a very powerful reinforcer, an event such as a divorce, an illness or death of a loved one, a layoff, etc. cause the person to experience this situation as a very unpleasant event.

b) Accumulation of small losses or small stressors

People develop in different areas. When a person does not feel fulfilled in her work, she also has a bad streak with her partner, has argued with her brother and does not usually go out with her friends much due to lack of time, suddenly a small insignificant event such as,.

c) Increased aversion

The human being experiences positive and negative events, but when the negative input exceeds the positive, the first invalidates the second.

For example, if a person suffers from a disease such as fibromyalgia, which causes a lot of pain, and this prevents him from enjoying himself, despite having his family, his friends are not able to experience pleasure.

d) Breaking of behavioral chains

This onset of depression occurs when a person experiences a change in their life, such as a promotion at work.

At first it is a positive thing, however, this new role implies traveling more often, greater responsibility, greater workload, high levels of stress, poor relationship with your old colleagues.

When a person experiences this series of events little by little a series of losses occur.

e) Symbolic loss

Sometimes, the negative event does not necessarily happen to yourself, but by witnessing a situation you rethink your life. For example, when you see that a neighbor of yours who was around your age has passed away, you rethink your life.

This loss that originates in a non-direct way causes the person to rethink their life and think about what they have done in the world, if they have achieved what they have always dreamed of, etc. sometimes the person is dissatisfied and becomes depressed.

Second stage: onset of depression

When experiencing any of these losses, the person feels sad. This sadness is prolonged and established, the person is not able to cope with this new situation and begins to get depressed.

This loss of reinforcers is experienced as critical and thinking that you cannot cope has a great psychological impact.

This emotional pain manifests itself in two changes, on the one hand, the automatic negative thoughts and on the other hand the unpleasant emotional and physical sensations.

As a consequence of thinking and feeling in this way, the person has less and less desire to do things. A general state of inhibition, apathy and lack of motivation occurs, leading to the next stage.

Third stage: Behavioral inhibition of pleasant activities

This emotional pain that manifests itself through thoughts and physiological sensations causes the person to stop doing those pleasant activities.

It is when inertia appears. It is understandable that if we have a low mood and thoughts are negative, we are not very predisposed to do things.

What we stop doing first are pleasant activities, that is, those that we like like going out with friends, doing sports, reading, listening to music, eating with the family. These are the voluntary activities that we do to enjoy.

What happens is that when the possibility of doing a pleasant activity arises, the thoughts that invade the mind of a depressed person are for example "I don't feel like it", "I don't want them to think I'm wrong", "I don't want them to ask me "," I'm sure I'm not having a good time ", these thoughts generate discomfort, so the person chooses not to go out and stay at home.

When a person decides not to do this activity in the short term, they feel relief, since they have managed to escape from this situation that causes them discomfort, but in the long term it generates more loss, since they lose the opportunity to enrich themselves from this activity.

Failing to do nice things is a loss of reinforcers added to the initial loss of reinforcers, thus closing the circuit of depression.

At this stage, the person continues to carry out the compulsory activities, that is, those activities that without generating pleasure are necessary to live, such as working, doing housework, washing, etc.

Fourth stage: behavioral inhibition of compulsory activities

When we stop doing things we like, we make it impossible to regain the proper level of positive reinforcers, thus making depression worse. This is when the person begins to feel worse.

Sometimes depression reaches a level that the person is unable to carry out compulsory activities such as working, taking care of their family, doing housework and self-care tasks such as grooming.

References

1. American Psychiatric Association (2014). DSM-5 Diagnostic and Statistical Manual of Mental Disorders. Pan American.
2. Barlow, D. Farchione, T, Fairholme, C. Boisseau C, Allen, L & Ehrenreich-May, J. (2011) Unified protocol for the transdiagnostic treatment of emotional disorders. Therapist manual and patient manual. Editorial Alliance.
3. Beck, AT; Rush, AJ; Shaw, BF; Emery, G. (2007): Cognitive therapy of depression.DDB. Lewinshon, PM; Gotlib, IH and Hautzinger, M. (1997): Behavioral treatment of unipolar depression. In: Caballo, V.: Manual for the cognitive-behavioral treatment of psychological disorders. XXI century
4. Belloch, A., Sandín, B., Ramos, F. (1994) Manual of psychopathology (volume II). McGrawHill.
5. Sevillá, J. and Pastor, C. (1996): Psychological Treatment of Depression. A step by step self-help manual. Publications of the Center for Behavior Therapy. Valencia.